[P-22] Mixed adenoid basal carcinoma and invasive squamous cell carcinoma of uterine cervix: a case report in Banglamung Hospital

Komkrit Suttichan

Department of Anatomical Pathology, Banglamung Hospital, Chonburi, Thailand

Background: Adenoid basal carcinoma (ABC) is an uncommon malignancy of the uterine cervix. Most of patients are elderly, asymptomatic, with abnormal cytology in annual Pap smear test. ABC could be associated with squamous dysplasia or another invasive carcinoma.

Case Presentation: The patient was a 71-year-old woman who visited Banglamung Hospital with bleeding per vagina and anemic symptom. Physical examination revealed exophytic mass of which size is 2 cm at the uterine cervix. Gynecologist performed excisional biopsy. The tumour consisted of two components: (1) basaloid cells arranged in cribriform pattern with focal squamous differentiation; and (2) infiltrating nests of polygonal-shaped tumour cells surrounded by desmoplastic stroma. Both tumour cell components showed diffuse cytoplasmic immunoreactivity for p16 and nuclear immunoreactivity for p63. The CD117 was negative for the basaloid component. Basement membrane material in the basaloid component also highlighted by PAS stain.

Discussion and Conclusion: ABC is the tumour associated with HPV infection. The morphological structure could be similar to adenoid cystic carcinoma (ACC). The immunohistochemical study, such as p16 and CD117, is helpful for differentiating ABC from ACC. Due to the ABC's association with HPV infection, thus the ABC expresses diffuse p16 stain. In contrast, ACC is in absence of p16 immunoreactivity, but expresses diffuse CD117 stain. In this case, the immunoprofile supports the diagnosis of ABC, which is mixed with invasive squamous cell carcinoma.